PDF(1463 KB)
江西地区23例18岁以下儿童2019冠状病毒病临床分析
吴华平, 李兵飞, 陈晓, 胡华著, 江淑爱, 程灏, 胡新和, 唐建新, 钟福初, 曾令文, 余伟, 袁妍, 伍先飞, 李育平, 郑宗利, 潘天波, 吴志兴, 袁金凤, 陈强
中国当代儿科杂志 ›› 2020, Vol. 22 ›› Issue (5) : 419-424.
PDF(1463 KB)
PDF(1463 KB)
江西地区23例18岁以下儿童2019冠状病毒病临床分析
Clinical features of coronavirus disease 2019 in children aged <18 years in Jiangxi, China: an analysis of 23 cases
目的 研究18岁以下儿童2019冠状病毒病（COVID-19）的临床特征。方法 回顾性分析江西地区2020年1月21日至2020年2月29日确诊的23例儿童COVID-19的临床资料（患儿年龄为3个月至17岁8个月）。结果 23例COVID-19患儿中，17例为家庭聚集性发病；无症状感染3例（13%），轻型6例（26%），普通型14例（61%）。发热16例（70%），咳嗽11例（48%），发热伴咳嗽8例（35%），肺部湿啰音8例（35%）。从发病或首次新型冠状病毒SARS-CoV-2核酸阳性至核酸转阴时间为6~24 d（中位数12 d）。3例白细胞总数降低，2例淋巴细胞下降，2例C反应蛋白增高，2例D-二聚体增高。12例肺部CT异常，其中肺内片状磨玻璃影9例。23例均应用了抗病毒治疗，均治愈出院。结论 18岁以下儿童COVID-19多为家庭聚集性发病，临床表现、实验室检查无特异性，症状较轻，预后较好。流行病学史在18岁以下儿童COVID-19诊断中非常重要。
Objective To study the clinical features of coronavirus disease 2019 (COVID-19) in children aged < 18 years. Methods A retrospective analysis was performed from the medical data of 23 children, aged from 3 months to 17 years and 8 months, who were diagnosed with COVID-19 in Jiangxi, China from January 21 to February 29, 2020. Results Of the 23 children with COVID-19, 17 had family aggregation. Three children (13%) had asymptomatic infection, 6 (26%) had mild type, and 14 (61%) had common type. Among these 23 children, 16 (70%) had fever, 11 (48%) had cough, 8 (35%) had fever and cough, and 8 (35%) had wet rales in the lungs. The period from disease onset or the first nucleic acid-positive detection of SARS-CoV-2 to the virus nucleic acid negative conversion was 6-24 days (median 12 days). Of the 23 children, 3 had a reduction in total leukocyte count, 2 had a reduction in lymphocytes, 2 had an increase in C-reactive protein, and 2 had an increase in D-dimer. Abnormal pulmonary CT findings were observed in 12 children, among whom 9 had patchy ground-glass opacities in both lungs. All 23 children received antiviral therapy and were recovered. Conclusions COVID-19 in children aged < 18 years often occurs with family aggregation, with no specific clinical manifestation and laboratory examination results. Most of these children have mild symptoms and a good prognosis. Epidemiological history is of particular importance in the diagnosis of COVID-19 in children aged < 18 years.
Coronavirus disease 2019 / Epidemiological history / Clinical feature / Child
[1] World Health Organization. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020[EB/OL]. (2020-02-11)[2020-03-17]. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020.
[2] Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related coronavirus:the species and its viruses-a statement of the Coronavirus Study Group[EB/OL]. (2020-02-07)[2020-03-22]. https://www.biorxiv.org/content/10.1101/2020.02.07.937862v1.full.pdf.
[3] 中华人民共和国国家卫生健康委员会. 关于印发新型冠状病毒感染相关ICD代码的通知[EB/OL]. (2020-2-14)[2020-03-17]. http://www.nhc.gov.cn/xcs/zhengcwj/202002/dcf3333b740f4fabad5f9f908d1fc5b4.shtml.
[4] Shen KL, Yang YH, Wang TY, et al. Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children:experts' consensus statement[J]. World J Pediatr, 2020. DOI:10.1007/s12519-020-00343-7. Epub ahead of print.
[5] 中华人民共和国国家卫生健康委员会. 新型冠状病毒感染的肺炎诊疗方案(第七版)[EB/OL]. (2020-03-04)[2020-03-17]. http://www.nhc.gov.cn/xcs/zhengcwj/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.
[6] 湖北省医学会儿科学分会, 武汉医学会儿科学分会, 湖北省儿科医疗质量控制中心. 湖北省儿童新型冠状病毒感染诊疗建议(试行第一版)[J]. 中国当代儿科杂志, 2020, 22(2):96-99.
[7] 中华医学会儿科学分会, 中华儿科杂志编辑委员会. 儿童2019新型冠状病毒感染的诊断与防治建议(试行第一版)[J]. 中华儿科杂志, 2020, 58(3):169-174.
[8] Cai J, Xu J, Lin D, et al. A case series of children with 2019 novel coronavirus infection:clinical and epidemiological features[J]. Clin Infect Dis, 2020. DOI:10.1093/cid/ciaa198. Epub ahead of print.
[9] Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia[J]. N Engl J Med, 2020, 382(13):1199-1207.
[10] 中华人民共和国国家卫生健康委员会. 中国-世界卫生组织新型冠状病毒肺炎(COVID-19)联合考察报告[EB/OL]. (2020-02-29)[2020-03-17]. http://www.nhc.gov.cn/jkj/s3578/202002/87fd92510d094e4b9bad597608f5cc2c.shtml.
[11] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223):497-506.
[12] 陈锋, 刘智胜, 张芙蓉, 等. 中国首例儿童危重型新型冠状病毒肺炎[J]. 中华儿科杂志, 2020, 58(3):179-182.
[13] 马耀玲, 夏胜英, 王敏, 等. 115例新型冠状病毒感染儿童的临床特点分析[J]. 中国当代儿科杂志, 2020, 22(4):290-293.
[14] 王端, 鞠秀丽, 谢峰, 等. 中国北方六省(自治区)儿童2019新型冠状病毒感染31例临床分析[J]. 中华儿科杂志, 2020. DOI:10.3760/cma.j.cn112140-20200225-00138. 网络预发表.
[15] 方峰, 罗小平. 面对2019新型冠状病毒感染重大疫情:儿科医生的思考[J]. 中华儿科杂志, 2020, 58(2):81-85.
[16] 周昀, 杨根东, 冯凯, 等. 婴幼儿2019冠状病毒病的临床特点及胸部CT表现[J]. 中国当代儿科杂志, 2020, 22(3):215-220.
[17] 宗晓龙, 李真玉, 魏殿军, 等. 血小板参与免疫炎症反应的研究进展[J]. 中华微生物学和免疫学杂志, 2018, 28(4):313-320.
[18] 宗晓龙, 马利锋, 李真玉, 等. 入院D二聚体水平与儿童社区获得性肺炎住院时间的关系[J]. 临床检验杂志, 2019, 37(9):700-704.
[19] 姜毅, 陆小霞, 金润铭, 等. 儿童新型冠状病毒感染诊断、治疗和预防专家共识(第二版)[J]. 中华实用儿科临床杂志, 2020, 35(2):143-150.
